Bilbao-Malavé Valentina, González-Zamora Jorge, Saenz de Viteri Manuel, de la Puente Miriam, Gándara Elsa, Casablanca-Piñera Anna, Boquera-Ventosa Claudia, Zarranz-Ventura Javier, Landecho Manuel F, García-Layana Alfredo
Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain.
Institut Clínic de Oftalmología (ICOF), Hospital Clínic de Barcelona, 08028 Barcelona, Spain.
Biomedicines. 2021 May 2;9(5):502. doi: 10.3390/biomedicines9050502.
The purpose of this study was to evaluate the long-term evolution of retinal changes in COVID-19 patients with bilateral pneumonia. A total of 17 COVID-19 patients underwent retinal imaging 6 months after hospital discharge with structural optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). The parafoveal retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) were significantly thinner in COVID-19 patients at 6 months compared to 0 months ( = <0.001 in both cases). In the optic nerve analysis, a significantly thinner RNFL was observed ( = 0.006) but persisted significantly thickened, compared to controls ( = 0.02). The vascular density (VD) at 6 months persisted significantly decreased when compared to the control group, and no significant differences were found with the 0 months evaluation; in addition, when analyzed separately, women showed a worsening in the VD. Moreover, a significantly greater foveal area zone (FAZ) ( = 0.003) was observed in COVID-19 patients at 6 months, compared to 0 months. The cotton wool spots (CWSs) observed at baseline were no longer present at 6 months, except for one patient that developed new ones. This study demonstrates that some of the previously known microvascular alterations resulting from COVID-19, persist over time and are still evident 6 months after hospital discharge in patients who have suffered from bilateral pneumonia.
本研究的目的是评估新冠肺炎双侧肺炎患者视网膜变化的长期演变情况。共有17例新冠肺炎患者在出院6个月后接受了视网膜成像检查，采用了结构光学相干断层扫描（OCT）和光学相干断层扫描血管造影（OCTA）技术。与0个月时相比，新冠肺炎患者在6个月时黄斑旁视网膜神经纤维层（RNFL）和神经节细胞层（GCL）明显变薄（两种情况均P<0.001）。在视神经分析中，观察到RNFL明显变薄（P=0.006），但与对照组相比仍明显增厚（P=0.02）。与对照组相比，6个月时的血管密度（VD）持续显著降低，与0个月评估时无显著差异；此外，单独分析时，女性的VD有所恶化。此外，与0个月时相比，新冠肺炎患者在6个月时观察到黄斑无血管区（FAZ）明显增大（P=0.003）。除了1例出现新的棉絮斑的患者外，基线时观察到的棉絮斑在6个月时已不再存在。这项研究表明，新冠肺炎导致的一些先前已知的微血管改变会随着时间持续存在，并且在患有双侧肺炎的患者出院6个月后仍然明显。
